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APPLIG.TION FOR CONSTFi..CT10N <br /> PERMIT <br /> the Lvery�een evcrett <br /> GTY OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> WINEP ���oGUSfQ�7"L� �o►'1'BR GIY ZIP R10N[ <br /> ✓,a�K f� w��r�<Fr �:.B�q�J,acz.or�. S�..orn.s �8/2/ GZ 3-09.�/ <br /> IEN�NT MNL�OUPLSS QtY ZIP P110NE <br /> N,A. _ <br /> �RGHRECTOROESiOrvEN �neiL�UDPE55 GIY ZIP R�ONE <br /> .S�9�E AJ orY�/E*�Z <br /> OENEP�LLONiRAG10R MML�ODRE59 pTY LIP %�ONE LICENSE• <br /> Nmr D6T6RMeriGv <br /> M[CN�N�L�LGONtNAGiOfI MAILADUPE54 CI1T 21P MIONE lIG[NSE• <br /> ur.�.{sB <br /> v�uMemacoNm.croa Measooncss cirv zm rnoH� uccHse. <br /> SjfNJc <br /> LL�SS OF N9i1N � <br /> NEW ❑ ADD�TION ❑ ALiEiiATION ❑ REPAIp ❑ DEIAOLITION ❑ WOODSTOVFJFRPL INSERT ❑ OUILDING RELOLATION <br /> TENANiIMP110VEMEHIOflIHTE010flRCMODELONLY CON1hCiPEfi50N�NDP110NEN0. ��3-033 <br /> CONTMCTPRICEOfWORK: �6l9-� Z�7 l�P� °= ,�?4q�HA �.UoNA J <br /> DE flI9EWORK�ND50WPEf TAGEIN VE� <br /> / — <br /> vn vo5EDu5EOFBVa v. ��./ IHERE�YCERTIFYTHATIHAVEREAOANOERAMMEDTHISRPPLICATIONFND <br /> ��en.i ��eorrnor�PA�TM�/YfS rouncor¢s� IWOWTIIESAMETOBE7RUENJOCOPRECTALLPROVISIONSOFLAWSAND <br /> �/"LO��"" p ORDINANCES GOVERNING TIi15 TYPE OP WORK WILI DE COMPLETED WItH <br /> �J � /^ ��-��{} WH[THFR SPEGFlED I IERLIN ON fJOT.THE GRANTING OF A PEPMIT DOES NOT <br /> :;�T2��g�ppK_[]_�-✓ or ��n� rA I�"y„�;� ��ESUMETOGIVEAUTIIOR�T'10VIOLATL'OACANCELTHEPROVISIONSOF <br /> ANY OTHER STAiE OR IOCAL LAw f7EGUUtING CONSTRUGTION OR TME PER� <br /> FORMANCE OF CONSTRUC710N.THAT I AM AUTHORIZEO BY THE OWNEH OF <br /> �� THIS Pf70PEFTV TO PEfiFORM iHE WORK FOR W NICH APPLIChTION IS MADE <br /> AND I COMPLY WITH THE STATE COIJTRACTORS LAW 1827 RCW AND <br /> 296200 WAC. <br /> SIOxqUliEOfGONIHAGi0110114UiHO�i2[OIGENi IUIG <br /> / —� � �� <br /> x e��l� --��.—�9—�— <br /> PfiWEC1�ODRE553��0 �G�r �I�C � �p �NISCIIYOUSM[ SIIGCHSENOM� IESSNn�aE I <br /> PLUMBING ECHANICAL _ <br /> Np. TYPE OF FIKTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILE7) A!L—!+/HNDLG UNITS—H.P. _. <br /> AATH7UB FORCEO Alfi SYSTEMS—B.T.U, M EA _ <br /> LAVATORV(WASHBASIN� UNIiHEATERS—O.T.U, M _ <br /> SNOWER CLOTHES�RYERO _ <br /> KITCHEN SINK+ DISP. VENIILATION FAN _ __ <br /> OISMWASHER fiANG[IIOOD __ <br /> l/1UNORY TRAY WATER HEA7ER _ <br /> CLOTHES WASHER WOOD STOVE _ <br /> URINhL METAL fIREPLACE 8 CIIIMNEV _ <br /> DRINKING FOUNiAIN FIREPLACE INSERT _ <br /> FLOOR DRAIN HEAT PUMP _ _ <br /> BACKFLOW PREVENTEFS GAS PIPIIJ6 _ <br /> qpOF DRAtNS—RAINLEADERS EXHAUST FAN _ <br /> SINK�SERVICE—�AR,ETC� — <br /> SUBTOTAL S SUDIOTAL S _ <br /> PEFMIT E PERMIT S _ <br /> TOTAL FE[ E TOTAL FEE S <br /> Ff10Ni5��N, �EMSEI6�GK, S�OESE1BAiK PUNCNEC NUMBEII fEE ��^�Qa AECEIPTND.��� <br /> -Zp 5 � 0�21��� S ���L <br /> useiorve �or�n[e V�G�NiLiIE FEEg VAUTATION FEE <br /> � � �rEB Il ll0 —" <br /> OUILDING dd'7 /G8 l, t97 so <br /> irreoveonsr. oCwrer�Dcvenouv nooFow���u/u+awa�s -- — <br /> euow•e��nG[y��INR �i—� �G � PLUMBW� __ <br /> .L <br /> sizeoro�oa. - uoor,Jsiom�s OYL OGGlUn1� �� MEGHANICAL <br /> 5� J N — <br /> I y2 � — NEIGIITLIMIUTION OTHER _ <br /> (O ��, <br /> �IRESPRINNLERSII[OUIPED OYE9 NO STATEBUILDINGSUiiCHARGE � � <br /> STATEENERGYSURCIiARGE ' � G � <br /> errucnvon�ccev r�ANserrn.er pU6lICW0(iKS <br /> �I /� TOTAL D�U <br />